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RT's should manage the O2

Posted Sep 09 2010 10:22am

I have worked in a few different hospitals in my 15 years as a Respiratory Therapist, and over the years I have noticed there have been different ideas in as to how to utilize the role of the Respiratory Therapist in their facility. The role I want to talk about is the role of the RT to manage oxygen therapy which patients are using.

I have worked in places where RT's monitor and manage patients on O2 and I have worked in places where the nurses and techs have free range to do what they want to with patients on O2. The second part is the one I don't agree with and I have worked in a place like this where the RN's just place a patient on any O2 the see fit and it seems that 3 lpm by nasal cannula was the norm here. I would come by and decrease the O2 on a patient on the 3 lpm patient who's spo2 was 99% and I would come back later to find them back up to 3 again with the spo2 at 100% even though they were 92-93% on 1 lpm which I dropped them to. Now this patient was on neb treatments also which were the only patients we knew were on O2 just because we were not informed of anyone placed on just O2. This I totally disagree with.

The reason's why I don't agree with this are the fact that I feel we can be of more use to these patients who need oxygen and notice if there is more oxygen consumption being used and more treatment modalities are needed, also on the other hand we can do a better job at weaning patients off of oxygen for people who don't need this much oxygen or are just plain getting better this in turn can save the patients and the hospital money is we are able to reduce the amount of time a patient is on oxygen. Then there is the whole getting paged to a room because a patient is being increased in their amount of oxygen they are using because they cannot keep their sat up to acceptable levels, and we have not been involved or notified of this patient being on O2 prior to this and now the RN's want help and answers. We are coming into this patients room blind with no prior knowledge of this patient and really no baseline as to what this patient is like but if we were following this patient due to being on O2 better decisions on our part can be made.

I guess all in all I am more a proponent for RT's being involved in patient care not just because they are on a vent or on neb treatments but also if they are using some type of respiratory modalities like oxygen, which IS A DRUG, and we have a real good working knowledge of. I believe we are RT's can really improve patients recovery or stave off possible problems because we might notice something with the patients oxygen which RN's and Techs might not see. If the RT's are keep out of the know of patients who are on O2 we can't be expected to really know much of what might be going on with a patient. Really how many times have you come upon a COPD retainer patient where the RN says they seem really lethargic and they are sitting there on a 6 lpm nasal cannula because their spo2 was only 90% on a 2 lpm nasal cannula. This is something we know, COPDers are good between 88-92%, that's where they usually live.